Injuries, both intentional and unintentional, are a leading cause of mortality and morbidity in childhood. While many injuries are treated by primary care physicians, only limited information is available about the scope and type of injuries treated by these physicians and no information has been collected about how frequently child abuse is responsible for injury related office visits. Both the office management of injuries and physician recognition of chid abuse as a cause of some of these injuries require further research. Recent shifts in health care financing and delivery patterns require that primary care physicians provide treatment for problems they may have referred to emergency departments or medical specialists in the past. Detailed information on injuries cared for in primary care practices would be helpful for understanding, planning and managing care, yet this information is not available. Child abuse is infrequently reported by office-based physicians. Physicians may fail to identify or report child abuse injuries until a life-threatening or fatal injury has occurred. Identification of less serious chid abuse injuries might enable physicians to intervene before abuse escalates and produces more serious consequences. Evaluation of this approach has not been possible, as research has not examined how frequently office-based physicians suspect physical abuse as a cause of the injuries that they evaluate, nor the behavior of physicians after they do identify such problems. This study has three goals: 1) to provide more information about the scope of injuries seen in the primary care setting and the case provided there, 2) to describe how frequently physicians suspect an injury is caused by child abuse and their management of those injuries, and 3) to test the feasibility of this research design and to refine the instruments for a nationwide study. Physicians in a regional practice network will be recruited to participate. Each physician will complete a survey form supplying information about their office setting, age, gender, attitudes and previous practice in identifying and reporting child abuse. Then for four successive weeks, each of fifty physicians will complete a short form about each office encounter. This study will collect demographic information of 20,000 office visits. For each of the estimated 1700 injury related visits, the treating physician will describe they type of injury, the cause of the injury and the office management of the injury. They will rate the severity of the injury and the likelihood that the injury was caused by child abuse. The data will be analyzed to describe the frequency of types of injuries, their causes, the spectrum of management provided in the office, and the patterns of office referral. The study will compare the percent of total injury with the percent of abuse injuries evaluated by each participating physician. The physician's in-office management of injuries versus referral for treatment patterns will be analyzed. The spectrum of child abuse injuries, physician reporting behavior, and risk factors attributing to families by physicians will be described.